Configuring Pre-Services Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Patient Cost Estimation Workflow

The cost estimation feature enables you to use the information within the application to provide an insight into the various costs associated with the different types of care. A practice, running in a real-time system, has a valid NextGen® Eligibility Verification license and is able to communicate with the real-time server. When an eligibility transaction is run, the system receives real-time eligibility (271) transaction file as response. A practice, running in non-real-time system, does not have a valid NextGen® Eligibility Verification license and retrieves values from the local database. If you are the administrator, you must complete the following configurations in File Maintenance. Set up payers in the payer master Set up providers in the provider master Set up the pricing for service item (SIM) codes and associate SIM codes with CPT®4 codes in the SIM library You can configure the following as needed and are not mandatory. Set up sliding fee schedules in the sliding fee schedul

Help Guide for NextGen® Enterprise PM 8

Set Payment Preferences for Pre-Services

Open NextGen® Enterprise PM. From the Admin menu, select Preferences > Practice. The Practice Preferences window opens. Select Pre-Services from the preference list. If the patient wants to pay in advance, enter the recommended percentage that needs to be collected from the patient in Patient Payment %. Select Update patient insurance with copay/deductible information from cost estimation to update the co-pay and deductible values in the patient insurance information from the current cost estimate. Select OK. Parent topic: Configuring Pre-Services Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Set Default Transaction Codes for Pre-Services Payment or Bad Debt Transaction

When you open the Payment Entry window from the Estimate Patient Cost window to make a payment, transaction codes already selected in the practice preferences are utilized by default. If you want to change transaction codes, you can change them as desired in the Payment Entry window. Open NextGen® Enterprise PM and select Admin > Preferences > Practice. On the Practice Preferences window, select Tran Codes from the preference list. In the Default Transaction Codes section, do the following: To make an advance payment, select a transaction code from Pre-Service Payment To make a transaction for a bad-debt encounter, select a transaction code from Pre-Service Bad Debt Select OK. Parent topic: Configuring Pre-Services Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Configuring Practice Preferences for Allowed Amount

The Search for Allowed Amount tab in the Pre-Service practice preferences enables you to select the source for allowed amount for cost estimation. The allowed amount for cost estimation can be sourced from the following: Contracts Transaction history If you are the administrator, you can set the source from where the allowed amount can be retrieved. You also select both the sources to retreive the allowed amount. Set Preference to Search for Allowed Amounts in Contracts You can set contracts as the source for allowed amounts. Set Preference to Search for Allowed Amounts in Transaction History You can set transaction history as the source for allowed amounts. Set Preference to Search for Allowed Amounts in Transaction History and Contract You can set preference to look for allowed amounts in transaction history and contract library. Parent topic: Configuring Pre-Services Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Pre-Services Cost Estimation

NextGen® Enterprise PM offers a pre-service solution that offers clear estimation for planned or completed services. You can perform patient cost estimation if you have administrator privileges to perform administration tasks for the practice. The cost estimation feature enables you to: Obtain a breakdown of financial responsibilities between the patient and insurance provider. Inform the patient about the amount payable by the patient before or after using the services and the amount that will be settled by the insurance provider. Collect timely payments from the person or patient. Print cost estimation results in customized formats. Keep plain text notes for the estimation. Associate diagnosis code for the estimation. View previous cost estimates. Visit the account profile, patient balance, and chart of the person or patient from the cost estimation. Generate and view cost estimate reports. Patient Cost Estimation Workflow After your administrator configures the library and master fi

Help Guide for NextGen® Enterprise PM 8

Configuring Practice Preferences for Coinsurance

The Search for Coinsurance tab in the Pre-Service practice preferences enables you to select the source for coinsurance for cost estimation. The source for coinsurance can be one of the following: Real-Time Transaction. The system fetches the coinsurance amount from the response of a real-time transaction. This option is available for a practice working in a real-time system. Transaction Details. The system fetches the coinsurance amount from details in the previous transaction. You must specify the date range. The system fetches the latest coinsurance amount from the transactions made within the specified date range. By default, the coinsurance amount is considered from the transactions made in the current year. This option is available for practices working in real-time and non-real-time systems. Contract. The system fetches the coinsurance amount from the settings made in the contract library. This option is available for practices working in real-time and non-real-time systems. All

Configuring Pre-Services Practice Preferences

Recommendations

Patient Cost Estimation Workflow

Set Payment Preferences for Pre-Services

Set Default Transaction Codes for Pre-Services Payment or Bad Debt Transaction

Configuring Practice Preferences for Allowed Amount

Pre-Services Cost Estimation

Configuring Practice Preferences for Coinsurance

Configuring Pre-Services Practice Preferences

Patient Cost Estimation Workflow

Set Payment Preferences for Pre-Services

Set Default Transaction Codes for Pre-Services Payment or Bad Debt Transaction

Configuring Practice Preferences for Allowed Amount

Pre-Services Cost Estimation

Configuring Practice Preferences for Coinsurance